Determination of 13C/12C ratios of urinary excreted boldenone and its main metabolite 5β‐androst‐1‐en‐17β‐ol‐3‐one

Boldenone (androsta–1,4–dien–17β–ol–3–one, Bo) is an anabolic steroid known to have been used in cattle breeding or equine sport as a doping agent for many years. Although not clinically approved for human application, Bo or its main metabolite 5β‐androst‐1‐en‐17β‐ol‐3‐one (BM1) were detected in several doping control samples. For more than 15 years the possibility of endogenous Bo production in human beings has been discussed. This is a challenging issue for doping control laboratories as Bo belongs to the list of prohibited substances of the World Anti‐Doping Agency and therefore the chance for false positive testing is significant. By GC/C/IRMS (gas chromatography/combustion/isotope ratio mass spectrometry) it should be possible to analyze the ¹³C/¹²C ratio of either Bo or BM1 and to distinguish whether their source is endogenous or exogenous. Therefore a method was developed to determine the ¹³C/¹²C ratios of Bo, BM1, pregnanediol, androsterone, etiocholanolone, and testosterone from a single urine specimen. The validity of the method was ensured by repeated processing of urine fortified with 2–50 ng/mL Bo and BM1. The specificity of the method was ensured by gas chromatography/mass spectrometry determinations. Out of 23 samples investigated throughout the last four years, 11 showed ¹³C/¹²C ratios of Bo or BM1 inconsistent with an exogenous origin. Two of these samples were collected from the same athlete within a one‐month interval, strongly indicating the chance of endogenous Bo production by this athlete. Copyright © 2010 John Wiley & Sons, Ltd.     

Long-term survival of endodontically treated,maxillary anterior teeth restored with either tapered or parallel-sided glass-fiber posts and full-ceramic crown coverage

Objectives

This retrospective study investigated the clinical effectiveness over up to 8 years of parallel-sided and of tapered glass-fiber posts, in combination with either hybrid composite or dual-cure composite resin core material, in endodontically treated, maxillary anterior teeth covered with full-ceramic crowns.

Methods

The study population comprised 192 patients and 526 endodontically treated teeth, with various degrees of hard-tissue loss, restored by the post-and-core technique. Four groups were defined based on post shape and core build-up materials, and within each group post-and-core restorations were assigned randomly with respect to root morphology. Inclusion criteria were symptom-free endodontic therapy, root-canal treatment with a minimum apical seal of 4 mm, application of rubber dam, need for post-and-core complex because of coronal tooth loss, and tooth with at least one residual coronal wall. Survival rate of the post-and-core restorations was determined using Kaplan–Meier statistical analysis.

Results

The restorations were examined clinically and radiologically; mean observation period was 5.3 years. The overall survival rate of glass-fiber post-and-core restorations was 98.5%. The survival rate for parallel-sided posts was 98.6% and for tapered posts was 96.8%. Survival rates for core build-up materials were 100% for dual-cure composite and 96.8% for hybrid light-cure composite.

Conclusions

For both glass-fiber post designs and for both core build-up materials, clinical performance was satisfactory. Survival was higher for teeth retaining four and three coronal walls.     

3-dimensional adaptive raw-data filter: evaluation in low dose chest multidetector-row computed tomography

OBJECTIVES: To evaluate a 3-dimensional adaptive raw-data filter in reducing streak artifacts in low dose chest computed tomographic (CT) images. METHODS: Fourteen adult patients who underwent low dose chest CT examination (parameters: 25 or 50 mAs, 120 kV) on 64-detector CTscanner were included in this study. We prepared 2 sets of contiguous 5-mm thick images by reconstruction with and without 3-dimensional adaptive raw-data filter (filter-processed and unprocessed images). Streak artifacts and visualization of peripheral vessels in both filter-processed and unprocessed images were evaluated using a 5-point scale. Upper, middle, and lower thorax were evaluated separately. RESULTS: The difference in artifact severity was statistically significant in upper and lower thorax (P = 0.002 and 0.03, respectively), whereas it was not significant in middle thorax (P = 0.13). The difference in the visibility of peripheral pulmonary vessels was not statistically significant in all anatomical regions. CONCLUSIONS: The 3-dimensional adaptive raw-data filter reduced streak artifacts in low dose chest CT in upper and lower thorax.     

Evaluation of pulmonary embolisms using coronal reformations on 64-row multidetector-row computed tomography: Comparison with axial images

OBJECTIVE: To evaluate coronal reformations of the chest on 64-row multidetector-row computed tomography (MDCT) for detection of pulmonary embolisms compared with axial images. METHODS: Thirty-eight consecutive patients who underwent pulmonary computed tomography angiography (CTA) on 64-row MDCT for a suspected pulmonary embolism were retrospectively studied. Contiguous 2-mm axial and coronal images were reviewed independently. A pulmonary embolism was assessed in the main, lobar, or segmental pulmonary arteries and was scored using a 5-point scale. RESULTS: A pulmonary embolism was demonstrated in 10% (4 of 38) of axial images and 16% (6 of 38) of coronal images. Interpretation was concordant in 95% to 100% of cases for a main or lobar pulmonary embolism and in 80% to 82% of cases for a segmental pulmonary embolism. Agreement of scores was almost perfect for a a main or lobar pulmonary embolism (mean weighted kappa value = 0.969) and moderate to good for a segmental pulmonary embolism (mean weighted kappa value = 0.560). CONCLUSION: Coronal reformations of the chest on 64-row MDCT were as informative as axial images for the detection of main, lobar, and segmental pulmonary embolisms.     

Evaluation of thoracic abnormalities on 64-row multi-detector row CT: comparison between axial images versus coronal reformations

PURPOSE: To evaluate the capability of coronal reformations of chest on 64-row MDCT in demonstrating thoracic abnormalities in comparison with axial images. MATERIALS AND METHODS: Thirty-eight consecutive patients who underwent pulmonary CTA on 64-row MDCT were retrospectively studied with institutional review board (IRB) approval. Contiguous 2 mm axial and coronal images were reviewed independently with a 1-week interval, by consensus reading of two board-certified radiologists. Overall image quality was graded using a five-point scale. Abnormalities in mediastinum, hilum, pulmonary vessels, aorta, heart, esophagus, pleura, chest wall, and lung parenchyma were scored: 1 = definitely absent, 2 = probably absent, 3 = equivocal, 4 = probably present, 5 = definitely present. Scores on axial and coronal images were compared using weighted kappa analysis. RESULTS: Overall image quality was not different with statistical relevance between axial and coronal images (mean/median scores; 3.7/4; 3.6/4, respectively, P = 0.286, Wilcoxon signed-rank test). Significant agreement was observed between axial and coronal scores (mean weighted kappa, 0.661; range, 0.362-1). Agreement was almost perfect for pneumothorax, lung and pleural mass, effusion and consolidation (weighted kappa=0.833-1); substantial for pulmonary embolism, trachea, mediastinal lymphadenopathy and non-skeletal chest wall lesion, heart, esophagus, and emphysema (weighted kappa, 0.618-0.799); moderate for atelectasis, mediastinum, hilar nodes, aorta, other lung lesions, skeletal chest wall lesions, linear scarring, nodules > 1 cm, pulmonary artery abnormalities and pleural thickening (weighted kappa, 0.405-0.592); and fair for nodules < 1 cm (weighted kappa = 0.362). CONCLUSION: Coronal reformations on 64-row MDCT had substantial agreement with axial images for evaluation of the majority of thoracic abnormalities.     

Coronal reformations of the chest on 64-row multi-detector row CT: evaluation of image quality in comparison with 16-, 8- and 4-row multi-detector row CT

PURPOSE: To evaluate image quality of coronal reformations of chest performed on 64-row MDCT in comparison with 16-, 8- and 4-row MDCT. MATERIALS AND METHODS: Consecutive patients who underwent pulmonary CT angiography using four different MDCT scanners were retrospectively studied with IRB approval: (1) n=30, 64-row MDCT; (2) n=30, 16-row MDCT; (3) n=30, 8-row MDCT; (4) n=30, 4-row MDCT. Coronal reformatted images (2 mm thickness and 2mm intervals for 64-row MDCT; 5 mm thickness and 5 mm intervals for 16-, 8- and 4-row MDCT) were evaluated by consensus reading of two board-certified radiologists who were blinded to scanner type. The image quality of overall chest appearance and individual thoracic structures including heart, aorta and pulmonary arteries was graded using five-point scale. Grades from four different scanners were compared using Kruskal-Wallis test. A second evaluation was performed in 48 randomly selected patients (12 patients for each scanner). Reproducibility was assessed using weighted-kappa analysis. RESULT: Significant reproducibility was observed between the first and second evaluations in 48 patients both for image quality of overall chest (weighted kappa=0.826) and each thoracic structure (mean weighted kappa=0.803; range, 0.729-0.858). Image quality of overall chest and individual thoracic structures differed significantly among four different MDCT groups, with 64-row MDCT having the highest grades, followed by 16-, 8- and 4-row MDCT (mean grades for overall chest in each scanner: 3.9, 3.0, 2.4 and 1.9, respectively) (P<0.0001 for overall chest and each thoracic structure). CONCLUSION: When comparing coronal reformations of chest using four different MDCT scanners, the 64-row MDCT had the highest image quality for overall chest appearance and individual thoracic structures, followed by 16-, 8- and finally 4-row MDCT.     

Multiple-image in-room CT imaging guidance for interventional procedures

This HIPAA-compliant study was approved by the institutional review board; informed consent was not required. The purpose of this study was to retrospectively compare room use time for interventional procedures performed with multiple-image multi-detector row computed tomographic (CT) fluoroscopy (n=196) and single-image spiral CT fluoroscopy (n=175). There was no statistically significant difference in age, sex, or procedural type between the two groups. The median room use time was 90 minutes (interquartile range, 65-120 minutes) for the single-image technique and 75 minutes (interquartile range, 60-105 minutes) for the multiple-image technique. A two-sample t test with equal variance assumption on the log-transformed data showed a statistically significant difference in log time (P<.001) between the two groups. This time savings could potentially have a substantial clinical effect on resource use and patient throughput.     

Cine CT during coughing for assessment of tracheomalacia: preliminary experience with 64-MDCT

OBJECTIVE: 64-MDCT is advantageous for functional imaging because of its high spatial and temporal resolution combined with its length of coverage. Our purpose is to describe the technical aspects of using 64-MDCT for cine CT during coughing and to share our preliminary clinical experience using this method. CONCLUSION: This method is technically feasible and offers a promising alternative to previous cine CT methods for diagnosing tracheomalacia.